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Danazol for treatment of women with symptoms caused by uterine fibroids

There is no evidence from randomised controlled trials demonstrating that the benefits of danazol outweigh its risks in treating uterine fibroids. Danazol is a synthetic isoxazole derivative chemically related to 17-ethinyl testosterone which creates a high androgen and low estrogen environment, resulting in the wasting of endometrium and shrinkage of fibroids. Despite its benefits, various undesirable side effects have also been reported. These include acne, hirsutism (excess hair in females, with an adult male pattern of distribution), weight gain, irritability, musculoskeletal pain, hot flushes, and breast atrophy, which many women may not tolerate. The review found no evidence demonstrating that the benefits of danazol outweigh the risks in treating uterine fibroids.

Background

Uterine fibroids (myomas, fibromyomas, leiomyomas) are the most common benign tumours of the female genital tract. Danazol, a synthetic isoxazole derivative chemically related to 17-ethinyl testosterone, has been used for many years for the treatment of women with uterine fibroids.This is an update of the review published in 2009.

Objectives

To evaluate the effectiveness and safety of danazol in women with uterine fibroids.

Search strategy

We searched the Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4); MEDLINE; EMBASE; Chinese Biomedical Disc; and the China National Knowledge Infrastructure for relevant trials (to December 2010). Attempts were made to identify trials from references in published studies. We also searched for ongoing trials in the five major clinical trials registries.

Selection criteria

Randomised controlled trials of danazol versus placebo or any other medical therapy in women with uterine fibroids confirmed by medical procedures, regardless of the women's symptoms or age. Studies of women with malignancies were excluded.

Data collection and analysis

Data extraction and risk of bias assessment were not performed because there were no identified studies.

Main results

We did not identify any studies which met our full inclusion criteria.

Authors' conclusions

There is no reliable evidence available from randomised controlled trials regarding the benefits or harms of the use of danazol for treating uterine fibroids.

Citation
Ke L-q-, Yang K, Li C-M, Li J. Danazol for uterine fibroids. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD007692. DOI: 10.1002/14651858.CD007692.pub2.

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